June 25, 2009

I’M ON PROF. JOHN BANZHAF’S PRESS-RELEASE SPAM LIST, and now he’s emailing that one of these defibrillators could have saved Michael Jackson:

Jackson’s Unnecessary? Death – Why No AED?
Inexpensive Device Could Have Saved Michael and Millions of Dollars

Michael Jackson’s death today may have been unnecessary, and might have been prevented by a device called an AED. Such a device, if present in his home, probably would have offered the only realistic chance of saving his life once sudden cardiac arrest [SCA] occurred, says public interest law professor John Banzhaf.

Unlike a heart attack, SCA is almost always fatal unless a defibrillator is used to shock the heart back into a normal rhythm. Indeed, about 95% of people who experience SCA die before reaching the hospital. C.P.R., which reportedly was administered by the ambulance crew which responded to Jackson, can in some cases keep the blood flowing, but defibrillation at the hospital usually occurs only after death or irreparable brain damage has already occurred.

Even under the most favorable conditions, there is usually no substitute for having a defibrillator in the home, which is where 80% of SCA attacks occur.

There’s actually some question whether that’s really true — while AEDs work great in public places, when people keel over at home there’s often no one around to apply the defibrillator. Given Michael Jackson’s usual gang of hangers-on, of course, that probably wouldn’t apply to him.

UPDATE: Chuck Simmins emails:

Have been a working EMT since 1995, I can tell you that a bad rhythm is not the only reason a heart arrests. A drug OD, an aneurysm, a prolonged seizure, any number of things. The defib works only if certain abnormal rhythms are present. There are also lots of rhythms that will kill you and the defib will not shock for.

CPR is almost universally unsuccessful in an unwitnessed arrest. The paragods worked him because of who he was. Joe Blow on the street would probably have been pronounced at the scene. They worked for 45 minutes, that means they did not have a sustainable rhythm for that long. Michael was dead and neither the paragods or a defib would have brought him back.

Yeah, AEDs are great, but they’re not magic. One day, everyone will have a built-in ICD, though it’ll probably do lots of other things, too.